If the FO has not added a VAPT flag to the case, see the instructions on adding the flag, Certified Electronic Folder (CEF) Flags in DI 81020.085.

For MDF cases not flagged by the FO, attach a printable flag to the front of the folder. For a printable flag, see the Exhibit of VAPT Flag in DI 11005.012G.

1. Fully address and develop all physical and mental allegations, including any possible impairment(s), either referenced or implied in any of the medical evidence, or other evidence in the claimant’s file. However, adjudicators may discontinue development at the point when a fully favorable allowance determination can be made. Refer to DI 24505.030E for additional instructions regarding this expedited processing.

2. When requesting medical records from a Military Health System, follow these instructions:

•For Developing Medical Evidence of Record (MER) from Military Health Sources, see DI 22505.023, and

•For Developing Medical Evidence of Record (MER) from the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Medical Facilities, see DI 22505.022.

3. Properly complete all required disability assessment forms.

1. Work activity is primarily the responsibility of the FO. However, DDS is responsible for reviewing the FO documentation to ensure they documented the work activity appropriately. If not, DDS should contact the FO for clarification.

2. DDS is responsible for the documentation when work activity is clearly not substantial gainful activity (SGA). For guidance, see Clearly Not SGA in section DI 10501.025, and for Special Employment Situations, see DI 10505.025.

Obtain information about the claimant’s ADLs to determine the functional effects of the physical and/or mental impairment(s) on the claimant’s ability to work.

1. ADLs with mental impairment allegations

ADLs are important in developing claims involving mental impairments, such as post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Adjudicators should be alert to the possibility of PTSD and TBI conditions even if they are not alleged. For information on developing claims involving mental impairments, refer to the following sections:

•DI 34001.032 Mental Disorders,

•DI 24583.005 Evaluating Mental Impairments Using the Psychiatric Review Technique (PRT)

2. ADLs with physical impairment allegations

ADLs are particularly useful in assessing how well a claimant with a traumatic injury is functioning at the time of the disability determination. For claims involving amputations(s), adjudicators should fully document the claimant’s ability or inability to use prosthetic devices effectively.

For additional information when developing ADLs with physical impairment allegations, refer to Evaluating Lay Evidence in DI 24515.012.

3. Third-party ADLs

The development of third-party ADLs is highly encouraged in all cases, especially those involving mental impairments and traumatic injuries. For guidance, see the following sections:

•DI 22511.011 Contacting Claimants and Collateral Sources,

•DI 22511.007 Sources of Evidence, and

•DI 22511.013 Technical Requirements When Securing Collateral Evidence.

Many of these military service members may be in transit and their addresses may have changed since the FO received their claims. For additional information on jurisdiction, see Disability Determination Services (DDS) and Social Security Administration (SSA) Jurisdictions for Initial and Subsequent Cases in DI 20101.001.

Be alert to the possibility of a closed period of disability as many of these claimants could have extended hospital and rehabilitation stays.

For additional information on closed periods of disability, see the following POMS sections:

•DI 25510.010 Closed Period Under Title II, and

•DI 25510.015 Closed Period Under Title XVI.